DESCRIPTION This application seeks funding to conduct a long-term longitudinal study of the course and outcome of a group of ICD-10 defined neurasthenia (NT) patients previously enrolled in a multi-site cross-sectional study involving an extensive clinical/ethnographic protocol. All subjects have been previously evaluated with the use of the SCID, HCL-90, HAMD, HADA, and a semi-structured ethnographic interview instrument (EMIC) for the collection of both qualitative and quantitative data. Similar to the parent grant, this study will examine the following issues in a Chinese patient population: (1) temporal stability of the NT diagnosis; (2) biopsychosocial predictors of the outcome and prognosis; and (3) cultural expressions of the illness during its course. This application will extend the parent study by adding an international, cross-site component that will not only significantly increase the sample size, but also allow the investigators to examine and compare the unity as well as diversity of Chinese cultures at the two sites, and how they differentially shape illness experiences and outcome. In addition to these research goals, the project also will further facilitate and maintain the collaboration in research and training between the two collaborative institutions, and foster further development of research programs in this and other related areas.